Monetary incentives for walking are effective

When insurance policy holders who were obese, were offered a discount in their health insurance premium if they exercised more, most of them achieved the fitness goals expected by the company.

Blue Care Network insurance company introduced a pedometer-based programme as a step to get insurance discounts. After a year, 97 per cent of the members in the programme had walked the 5,000 steps a day as expected of them.

"There are ethical debates around the idea of forcing someone to be personally responsible for health care costs related to not exercising, but we expect to see more of these approaches to financially motivate healthier behaviours," says senior author Caroline R. Richardson, M.D., assistant professor in the U-M Department of Family Medicine, investigator with the VA Center for Clinical Management Research and member of the U-M Institute for Healthcare Policy and Innovation.

"Our evaluation of Blue Care's incentive programme showed a surprisingly high rate of people who enrolled in the Internet-mediated walking program and stuck with it—even among those who were initially hostile to the idea. Wellness interventions like this hold significant promise for encouraging physical activity among those who are obese."

One-third of the members hated the idea of being forced to exercise but nevertheless complied with the rules. Two-third of the participants actually liked the idea of financial incentives for staying healthy.

"Our findings suggest that incentivised wellness programmes are acceptable to many individuals and that these programmes encourage healthy behaviours," says lead author Donna Zulman, M.D., Instructor in the Division of General Medical Disciplines at Stanford University and research investigator at the VA Palo Alto Health Care System.

"Comprehensive evaluations are needed to determine whether participation in these programmes translates to meaningful changes in health and costs of health care."

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